It is possible that your physician or orthopedic surgeon has recommended you pre-medicate either temporarily or over your lifetime before receiving dental treatment. The guidelines for prophylactic antibiotics are constantly reviewed and revised, based on updated evidence-based data. As of late 2021, the American Dental Association and the American Heart Association have determined that patients with heart conditions such as artificial heart valves, heart transplants, unrepaired cyanotic congenital heart disease, and repaired heart defects, should premedicate with antibiotics six months after their treatment. If your dental appointment falls within six months of a recommended condition, you may get the prescription from our dental office. If your physician or surgeon recommends a lifetime regimen, they are responsible for providing that prescription.
Premedication is necessary during procedures where there can be a mixture of oral bacteria and the general bloodstream. These procedures include dental cleanings and scaling and root planing, root canals, extractions, fillings, or crown preparations. Procedures like x-rays, denture placements or adjustments, anesthetic injections, crown cementations, and non-invasive orthodontic treatment do not require prophylactic antibiotics.
When a patient is required to premedicate with antibiotics, the most common treatment is one dose of amoxicillin one hour before your appointment. If you are allergic to penicillins, clindamycin is often used. If you happen to forget to premedicate, your dentist may have some available in the office, or they may need to reschedule your appointment.
Why Doesn’t Everyone Premedicate?
Most patients’ immune systems are healthy enough to fight any bacteria that may enter the bloodstream. Infections after dental procedures are rare and unnecessary overuse of antibiotics leads to antibiotic resistance. If your medical history does not require antibiotic prophylaxis, taking them is unnecessary.
The guidelines for prophylactic antibiotics are always being reviewed and updated. Many years ago, patients with heart murmurs, a history of rheumatic fever, and joint replacements needed to premedicate, but this is no longer the case. Dr. Ewell stays up to date with the latest guidelines through continuing education and can advise you on what the current studies recommend.
If you need a prophylactic antibiotic, make sure your prescription is filled before each visit. If you run out of medicine, let us know as soon as possible before your appointment.
It’s important to remember that not every patient with a compromised immune system or heart condition needs prophylactic antibiotics. Your doctors will advise you on the appropriate regimen for your health.